[Surgical treatment of colorectal cancer]

Any therapeutic decision in colorectal cancer must be taken by multidisciplinary coordination meeting. The treatment of non-metastatic colon cancer based on the first surgery with complete excision, dissection and respect distal margins. In case of node-adjuvant chemotherapy improves survival. For rectal cancer, surgery may be preceded by chemo radiotherapy for locally advanced cancers. The sphincter preservation rate in entrained teams can reach 90%. The abdominoperineal resection is indicated in cases of tumor invading the external sphincter. In colorectal cancer the most important prognostic factor is the histological stage (invasion of the intestinal wall and lymph node involvement). If the breach only affects the mucosal healing is 100%. If the entire wall is reached, node negative the survival is 60%. However, if the lymph nodes are affected survival drop 30-40%. Finally in the presence of synchronous liver metastases curative treatment options can be considered and must be defined in the multidisciplinary coordination meeting. Surgery of liver metastases can achieve cure rates of 30% at 5 years.